131402 20240208155436.0 doi 10.1016/j.jclinane.2021.110378 sideral 127938 ART-2021-127938 eng Zorrilla-Vaca, Andres Institutional factors associated with adherence to enhanced recovery protocols for colorectal surgery: Secondary analysis of a multicenter study 2021 Introduction Adherence to Enhanced Recovery Protocols (ERPs) is associated with faster functional recovery, better patient satisfaction, lower complication rates and reduced length of hospital stay. Understanding institutional barriers and facilitators is essential for improving adherence to ERPs. The purpose of this study was to identify institutional factors associated with adherence to an ERP for colorectal surgery. Methods A secondary analysis of a nationwide study was conducted including 686 patients who underwent colorectal surgery across twenty-one institutions in Spain. Adherence to ERPs was calculated based upon the components recommended by the Enhanced Recovery After Surgery (ERAS®) Society. Institutional characteristics (i.e., case volume, ERP duration, anesthesia staff size, multidisciplinary meetings, leadership discipline) were captured from each participating program. Multivariable regression was performed to determine characteristics associated with adherence. Results The median adherence to ERAS was 68.2% (IQR 59.1%–81.8%). Multivariable linear regression revealed that anesthesiologist leadership (+5.49%, 95%CI +2.81% to +8.18%, P < 0.01), duration of ERAS implementation (+0.46% per year, 95%CI +0.06% to +0.86%, P < 0.01) and the use of regular multidisciplinary meetings (+4.66%, 95%CI +0.06 to +7.74%, P < 0.01) were independently associated with greater adherence. Case volume (−2.38% per 4 cases weekly, 95%CI -3.03 to −1.74, P < 0.01) and number of anesthesia providers (−1.19% per 10 providers, 95%CI +2.23 to −8.18%, P < 0.01) were negatively associated with adherence. Conclusion Adherence to ERPs is strongly associated with anesthesiology leadership, regular multidisciplinary meetings, and program duration, whereas case volume and the size of the anesthesia staff were potential barriers. These findings highlight the importance of strong leadership, experience and establishing a multidisciplinary team when developing an ERP for colorectal surgery. info:eu-repo/semantics/closedAccess All rights reserved http://www.europeana.eu/rights/rr-f/ 9.375 2021 ANESTHESIOLOGY 3 / 34 = 0.088 2021 Q1 T1 1.081 2021 Anesthesiology and Pain Medicine 2021 Q1 6.7 2021 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Stone, Alexander B. Ripolles-Melchor, Javier Abad-Motos, Ane Ramirez-Rodriguez, Jose M. Universidad de Zaragoza (orcid)0000-0001-7964-1166 Galan-Menendez, Patricia Mena, Gabriel E. Grant, Michael C. Martínez-Ubieto, Javier Universidad de Zaragoza (orcid)0000-0003-2462-1904 The Spanish Perioperative Audit and Research Network (RedGERM) Power Investigators Group 1013 090 Universidad de Zaragoza Dpto. Cirugía Área Cirugía 74 (2021), 110378 [6 pp.] J. clin. anesth. JOURNAL OF CLINICAL ANESTHESIA 0952-8180 382997 http://zaguan.unizar.es/record/131402/files/texto_completo.pdf Versión publicada 2430089 http://zaguan.unizar.es/record/131402/files/texto_completo.jpg?subformat=icon icon Versión publicada oai:zaguan.unizar.es:131402 articulos driver 2024-02-08-14:39:10 ARTICLE